How does pregnancy and childbirth affect my body?

When you are pregnant, your body changes in many ways. Your muscles stretch, and ligaments soften, especially those in your abdomen and your pelvic floor. Pelvic floor weakness can start during pregnancy and may continue after birth. If you've had multiple births, assisted births (with forceps), tearing, or babies over 4kg you are at greater risk of injury.

Will having a baby cause incontinence?

If you’ve had a baby, then you have around 1 in 3 chance of bladder and bowel problems (incontinence).

If you had bladder or bowel symptoms, such as irritable bowel syndrome or an overactive bladder before you were pregnant, you are more likely to have this problem worsen after pregnancy.

You are also more likely to have incontinence after pregnancy if:

• your baby is large
• your labour was long (especially the second (pushing) stage)
• you had a difficult vaginal delivery or needed stitches

You may also experience incontinence if you’ve had an easy birth.

Incontinence after pregnancy will often improve in the first 6 months, as the pelvic floor muscles and nerves recover. Regular pelvic floor muscle exercises before, during and after pregnancy will help.

How can I strengthen my pelvic floor to avoid incontinence?

It is important to do exercises to strengthen your pelvic floor and abdominal muscles while you are pregnant, but if you’ve already had your baby, it’s not too late to start.

If you've had a vaginal birth, you only need to wait 2 days to begin pelvic floor exercises. If you had a caesarean birth, it's best to wait 5 days. If you feel any pain, stop doing the exercises and see a physiotherapist or your midwife for advice.

To exercise your pelvic floor muscles:

• squeeze the muscles all around your front and back passages
• lift them up and inwards, as if you are trying to stop urine (wee) from escaping
• relax for about 5 seconds
• repeat up to 10 times

You can do these exercises several times each day, wherever you are. Practicing this routine daily will improve the strength and endurance of your pelvic floor muscles.

Pelvic floor exercises are most effective when individually tailored and monitored. Continence and women's health or pelvic floor physiotherapists can assess your pelvic floor function, and design an exercise program to meet your needs.

Pregnancy, Birth and Baby's service directory can help you find women's health or pelvic floor physiotherapists, or call the National Continence Helpline on 1800 33 00 66. Your GP may also be able to refer you to a pelvic floor physiotherapist.

How can I strengthen my abdominal muscles?

Doing abdominal exercises every day after you give birth can help you regain your strength and help with back and stomach support. Don't do sit-ups for at least 12 weeks after giving birth. Instead, it's best to do pelvic tilts and abdominal bracing exercises.

To perform pelvic tilts:

• lie, stand or sit with your knees bent and your feet flat
• gently flatten the curve of your lower back by tilting your pelvis backwards
• hold for 3 to 5 seconds
• repeat 5 to 10 times

To perform abdominal bracing:

• lie, sit or stand
• gently draw your belly button in towards your spine
• hold for 5 to 10 seconds
• repeat 5 to 10 times

How can I care for my back?

It's important to look after your back to help prevent backache and injury. New parents are at risk of back injury because they are lifting and bending more than usual.

You can help look after your back by:

• keeping good posture and bend your knees
• working at benches or tables at waist height
• using chairs with good back support
• not lifting anything heavier than your baby for the first 6 weeks

How do I establish healthy habits?

Regular exercises can help you strengthen your muscles, to help you look after your body during pregnancy, and to recover after childbirth.

Many hospitals offer postnatal physiotherapy classes, where you can learn the best exercises to do under professional guidance.

Some important habits include:

• exercise — walk every day, and do daily pelvic floor and abdominal exercises
• good bladder habits — drink plenty of fluids and only urinate when your bladder feels full (don't go 'just in case')
• good bowel habits — avoid constipation and straining by eating plenty of high fibre foods, such as wholegrains, fruit and vegetables